Ear, Nose and Throat Department, Charing Cross Hospital, London, United Kingdom.
Laryngoscope. 2011 May;121(5):1049-54. doi: 10.1002/lary.21450.
Viagra and PDE-5 inhibitors use has mushroomed since its launch over a decade ago. A growing body of evidence indicates significant morbidity associated with the side effect profile of this class of drug. Hearing loss associated with PDE-5 inhibitor use has recently been reported, but few studies have evaluated the causal link.
To review and scrutinise the current literature on the subject and propose possible physiologic mechanisms and to investigate the global reporting of this side effect.
Pharmacovigilance agencies around North America, Europe, and Australasia were contacted requesting reports of hearing loss associated with PDE-5 inhibitors. Reports were scrutinised to exclude those where others causes of hearing loss existed.
Forty-seven cases of sensorineural hearing loss with a temporal association with PDE-5 inhibitor ingestion were obtained from both published literature and pharmacovigilance agencies. Cases had a mean age 56.6 years, male-to-female ratio of 7:1. Eighty-eight percent of reports were unilateral with an even left/right distribution. Hearing loss occurred within 24 hours of ingestion of PDE-5 inhibitor in 66.7% (n = 18) of cases. Sildenafil accounted for over 50% of cases.
There is increasing evidence that PDE-5 inhibitors may induce sensorineural hearing loss via plausible physiological mechanisms. There needs to be more awareness of this disabling side effect among healthcare professionals responsible for prescribing this drug.
伟哥和 PDE-5 抑制剂自十多年前推出以来，使用量呈爆炸式增长。越来越多的证据表明，这类药物的副作用与显著的发病率有关。最近有报道称 PDE-5 抑制剂的使用与听力损失有关，但很少有研究评估其因果关系。
回顾和审查该主题的现有文献，并提出可能的生理机制，并调查这种副作用的全球报告。
联系了北美、欧洲和澳大拉西亚的药物警戒机构，要求报告与 PDE-5 抑制剂相关的听力损失。对报告进行了审查，以排除其他原因引起的听力损失。
从已发表的文献和药物警戒机构中获得了 47 例与 PDE-5 抑制剂摄入有关的感觉神经性听力损失病例，这些病例与 PDE-5 抑制剂摄入有关。这些病例的平均年龄为 56.6 岁，男女比例为 7:1。88%的报告为单侧，左右分布均匀。83.3%（n = 39）的听力损失发生在 PDE-5 抑制剂摄入后 24 小时内。西地那非占病例的 50%以上。
越来越多的证据表明，PDE-5 抑制剂可能通过合理的生理机制引起感觉神经性听力损失。负责开具这种药物的医疗保健专业人员需要更加意识到这种致残的副作用。
